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dc.contributor.authorJester, Rebecca
dc.contributor.authorRodney, Amanda
dc.date.accessioned2021-02-19T12:33:35Z
dc.date.available2021-02-19T12:33:35Z
dc.date.issued2021-02-16
dc.identifier.citationJester, R. and Rodney, A. (2021) The relationship between obesity and primary total knee replacement: A scoping review of the literature. International Journal of Orthopaedic and Trauma Nursing. https://doi.org/10.1016/j.ijotn.2021.100850en
dc.identifier.issn1878-1241en
dc.identifier.doi10.1016/j.ijotn.2021.100850en
dc.identifier.urihttp://hdl.handle.net/2436/623947
dc.descriptionThis is an accepted manuscript of an article published by Elsevier in International Journal of Orthopaedic and Trauma Nursing, available online at: https://doi.org/10.1016/j.ijotn.2021.100850 The accepted version of the publication may differ from the final published version.en
dc.description.abstractBackground Primary Total Knee Replacement (TKR) is one of the most commonly performed elective orthopaedic procedures globally. Many of the patients undergoing this type of surgery are overweight or obese. In the UK clinical commissioning groups have imposed arbitrary Body Mass Index (BMI) thresholds for TKR surgery. Many obese patients undergoing TKR believe they will lose weight following the procedure because of increased mobility. Aim This paper aims to present the findings of a scoping literature review about the relationship between obesity and primary TKR and to make recommendations for clinical practice, education and policy Methods A scoping literature review investigated the impact of BMI/body weight on the need for TKR, the impact of body weight and or BMI on patient outcomes following TKR; weight loss/gain following TKR and the implications of obesity on cost of TKR. Findings Seventy-one papers were included in the review. Seven studies reported statistically significant associations between increased BMI/obesity with the need for TKR. Thirty of the studies reported worse outcomes for obese patients compared to non-obese comparators. Forty of the studies reported no difference between obese and non-obese participants including some where outcomes of obese patients were better than non-obese comparators. Eight studies reported on changes to weight before and after TKR, 3 of the studies reporting a higher percentage losing weight than gaining weight and 4 studies reported obese patients gained weight. The 8th study reported morbidly obese patients largely returned to their baseline BMI postoperatively. Conclusion The findings of the review challenge the legitimacy of setting BMI thresholds to control access to TKR surgery. There is an urgent need to develop evidence based approaches to support weight loss and weight management for this group of patients. Obese patients undergoing TKR should receive specific information regarding potential additional risk of complications and poorer outcomes. There is a need for health promotion regarding the association of being overweight/ obese in young adulthood and developing osteoarthritis of the knee joints requiring TKR in middle and older age.en
dc.formatapplication/pdfen
dc.languageen
dc.language.isoenen
dc.publisherElsevieren
dc.relation.urlhttps://www.sciencedirect.com/science/article/abs/pii/S1878124121000071?via%3Dihuben
dc.subjectoutcomesen
dc.subjectcosten
dc.subjecttotal knee replacementen
dc.subjectobesityen
dc.titleThe relationship between obesity and primary total knee replacement: A scoping review of the literatureen
dc.typeJournal articleen
dc.identifier.journalInternational Journal of Orthopaedic and Trauma Nursingen
dc.date.updated2021-02-18T14:06:10Z
dc.date.accepted2021-02-10
rioxxterms.funderuniversity of wolverhamptonen
rioxxterms.identifier.projectUOW19022021RJen
rioxxterms.versionAMen
rioxxterms.licenseref.urihttps://creativecommons.org/licenses/by-nc-nd/4.0/en
rioxxterms.licenseref.startdate2022-02-16en
dc.source.beginpage100850
dc.source.endpage100850
dc.description.versionPublished version
refterms.dateFCD2021-02-19T12:32:18Z
refterms.versionFCDAM


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